Abstract These updated guidelines from the Infectious Diseases Community of Practice American Society Transplantation provide an update on potential drug‐drug interactions between anti‐infectives and immunosuppressants, which are most notable with calcineurin mTOR inhibitors. Drug‐drug may occur through pharmacokinetic mechanisms leading to altered drug concentrations either anti‐infective or immunosuppressive drug, by pharmacodynamic increasing decreasing efficacy toxicity medications. Many...

Renal transplant has become an important option for human immunodeficiency virus (HIV)–infected patients with end-stage renal disease; however, these experience a high rate of acute cellular rejection (ACR). Guidelines do not currently exist the optimal duration viral suppression prior to transplantation. In retrospective cohort analysis 47 HIV-infected recipients, we compared ACR between based on length time Of who achieved >6 months but less than 2 years transplantation (n = 15), 60%...

Abstract Background Protease inhibitors (PI) pose a challenge post‐transplant due to significant drug interactions with calcineurin inhibitors, prompting many clinicians convert patients non‐interacting regimens prior transplant. The purpose of this study was examine the impact PI‐based on graft outcomes in HIV‐infected renal transplant recipients. Methods In retrospective cohort study, 50 allograft recipients (27 receiving PI regimen, 23 non‐PI regimen) transplanted between 2003‐2015 were...

The optimal choice of induction immunosuppression for elderly kidney transplant recipients remains unclear. Although alemtuzumab has been associated with escalating risk death and graft loss in this population, not adequately explored. purpose study was to compare the safety efficacy basiliximab population.This is a retrospective matched cohort aged ≥65 years. Patients who received were (1:2) control. primary outcome allograft survival. incidence acute rejection, infection, all-cause...

Renal transplantation between monozygous identical twins provides an opportunity to utilize minimal immunosuppression maintain stable allograft function, thereby alleviating the toxicities of immunosuppressive therapy. Despite monozygosity, there is a possibility discordant protein presentation in that could trigger alloimmune response and lead graft injury. Therefore, optimal regimen this patient population unknown, safety withdrawal remains controversial. Herein, we describe two patients...

Abstract We performed a prospective, 12‐month, single‐center, nonrandomized, open‐label pilot study to investigate the use of belatacept therapy combined with alemtuzumab induction in renal allografts preexisting pathology, as these kidneys may be more susceptible additional toxicity when exposed calcineurin inhibitors posttransplant. Nineteen recipients were matched retrospectively cohort tacrolimus on basis preimplantation pathology. The estimated glomerular filtration rate was not...

Abstract Background Cytomegalovirus (CMV) outcomes with valganciclovir prophylaxis in renal transplant recipients experiencing delayed graft function (DGF) are unclear. Methods This single center, retrospective, cohort study of CMV high‐risk (D+/R− alemtuzumab induction) deceased donor receiving assessed patients DGF (n = 72) versus those immediate (IGF; n 66). Results viremia by 12 months occurred at similar rates the IGF and groups (30.3% vs 26.4%, respectively, P 0.71) 89.7% (35/39) all...

Abstract Background Elderly patients are the fastest growing population requiring renal replacement therapy. As previous studies have shown a survival benefit of kidney transplantation compared to dialysis for end‐stage disease, we sought evaluate if this extends octogenarians. Methods This was single‐center retrospective cohort study allograft recipients ≥80 years transplanted from 1999 2014 who were listed during same period that did not proceed transplantation. A secondary matched group...

Advanced liver disease or cirrhosis is associated with an increased risk of infections; however, the impact high pretransplant model for end-stage (MELD) score on cytomegalovirus (CMV) viremia after transplantation unknown.This single-center, retrospective, cohort study evaluated CMV high-risk (CMV immunoglobulin G D+/R-) transplant recipients who received valganciclovir prophylaxis 3 months between 2009 and 2019. Patients were stratified by MELD <35 (low MELD) ≥35 (high MELD). The primary...

Abstract The efficacy and safety of early steroid withdrawal (ESW) in Black renal transplant recipients (RTR) remains uncertain, especially when combined with non‐lymphocyte depleting induction. This study compared patient graft outcomes older Non‐Black RTR who received basiliximab induction followed by ESW. Included subjects this single center, retrospective were first‐time deceased living donor aged over 65 years therapy an oral prednisone taper starting POD3 which was discontinued POD21...

Purpose: Due to high rates of acute rejection, lymphocyte depleting agents ( rATG or alemtuzumab) (LD) are increasingly used for induction therapy in HIV infected organ transplant recipients. However this could increase the risk serious opportunistic infections. We assessed risks infection patients who received basiliximab (BSX) compared LD induction. Methods: All a kidney at our center from 9/2003 through 6/2013 were evaluated development an (OI), any infection, malignancy, death 24 months...

Purpose: The introduction of highly active antiretroviral therapy (HAART) has made kidney transplantation among HIV-infected patients possible. Despite the improvement in overall transplant outcomes, incidence acute cellular rejection (AR) this population is high. reasons for have not been fully studied. We sought to examine association induction agent with AR and graft outcomes these patients. Methods: From 2003 2013, our institution performed 45 renal transplants individuals. 34 (75.6%)...

Abstract Solid organ transplantation is a lifesaving procedure for thousands of people with irreversible end diseases. A multidisciplinary approach inclusion pharmacist in the care transplant recipients highly desired and may necessitate addition pharmacy resources to existing teams meet these growing needs. By understanding leveraging current landscape leadership priorities, gathering data help define value services, compiling formal proposal, one can systematically expansion clinical...

This study assessed whether personality testing of postgraduate year 1 (PGY1) pharmacy residency applicants was feasible and predicted important selection outcomes, including interview offers.Applicants to the PGY1 program at a large academic medical center were invited complete 50-item online test based on 5-factor model (ie, "Big Five"). Scores sealed until after matching, which point they compared screening, interview, ranking match outcomes. Endpoints interest included feasibility (eg,...

Introduction: The occurrence of simultaneous liver kidney transplantation has greatly increased; however, the ideal induction and maintenance immunosuppression remains unknown. Question: This evaluation aimed to determine if corticosteroid only in transplant recipients provided adequate prophylaxis against rejection when compared basiliximab. Design: was a single center, retrospective, cohort study adult from June 2010 2019 receiving (N = 41) or basiliximab 42) induction. Results: Liver...

Background: Protease inhibitors (PI) pose a challenge post-transplant due to significant drug interactions with calcineurin (CNI), leading altered CNI dosing and the potential for increased exposure. This has prompted many clinicians convert patients newer, non-CNI interacting antiretroviral (ARV) agents prior transplant. The purpose of this study was examine impact PI-based regimens on graft outcomes in HIV-infected renal transplant recipients. Methods: Retrospective allograft recipients...

Background: In an effort to avoid perioperative renal dysfunction in liver transplant recipients, our center has incorporated transient belatacept therapy patients intolerant of conventional calcineurin inhibitor (CNI)-based regimens. As early clinical trials suggested increased risk graft loss and death, recipient safety monitoring is critical this initiative. Methods: A retrospective review adult recipients receiving was conducted under IRB approval. Belatacept use approved by...

Background: Human Metapneumovirus (hMPV) has been well recognized as a cause of respiratory illness in lung and bone marrow transplant recipients. However, little reported the abdominal population. The purpose this study was to report presentation, clinical course, outcomes hMPV infection series kidney pancreas Methods: This retrospective hospitalized pts who were diagnosed with by polymerase chain reaction between January 2011 June 2013. Results: During period 11 positive BAL or...

Purpose: Peritransplant renal dysfunction has been associated with poor long-term patient and graft survival in liver transplant recipients. Belatacept was utilized the perioperative period patients acute kidney injury an effort to minimize toxicities calcineurin inhibitor (CNI)-based immunosuppression. Methods: A retrospective review of adult recipients receiving belatacept conducted under IRB approval. use approved by our institutional Pharmacy Therapeutics Committee as a bridge recovery...

Background: There is limited data regarding the histological findings in pancreas allografts with graft dysfunction and predictive value of for outcomes. We sought to determine rate type acute rejection impact on survival. Methods: 132 transplant recipients required a total 214 biopsies dysfunction, form elevation amylase/lipase or hyperglycemia, between April 2003 December 2012. Biopsies were evaluated T-cell-mediated (ACMR) antibody-mediated (AMR). scored according applicable criteria at...

Background: Renal transplantation has become a more common occurrence in HIV-infected individuals. The post-transplant antiretroviral regimen is one of the challenges this population due to drug interactions with immunosuppressive agents. Regimens containing protease inhibitors (PI) pose challenge post-transplant, leading altered calcineurin inhibitor (CNI) dosing and potential for increased CNI exposure. This led utilization newer agents that lack significant CNI. purpose study was examine...